Children and Young People: introduction | 1

1 Introduction

1.1 What this chapter covers

This chapter presents data on issues affecting the health and wellbeing of children and young people in the London Borough of Hackney and the City of London. The analysis identifies areas of unmet need through examination of health inequalities and by comparing local data with other areas and over time. The chapter also outlines the evidence for what works in meeting children and young people’s health needs, and describes key services and support available locally with regards to prevention, identification and care/treatment.

Much of the information contained within this chapter has been drawn from two health needs assessments conducted over the period 2015-2016 – one for 0-5 year olds, and the other for 5-19 year olds. These needs assessments can be found on the Hackney Council website. 1

The main local services for children and young people are listed within this chapter to highlight the range of support that is available. However, this is not intended to be a comprehensive directory of all local services. To search for further services in Hackney, please consult the ‘Children & Young People’s Resource Guide’, which has recently been updated (July 2016) by Hackney Children’s and Young People’s Services (CYPS).2

Please note, given the small number of children and young people resident in the City of London, many services are shared with neighbouring boroughs. However, they are not always shared with Hackney (for instance, youth offending is shared with Tower Hamlets). Where possible, services covering the City of London have been described. However, given the wide scope of this chapter, it has not been possible to describe all of these services, particularly where they are fragmented. The chapter has been structured according to Box 1.

1 http://www.hackney.gov.uk/jsna 2 http://www.hackney.gov.uk/media/3989/CYPS-resource-guide-for-professionals/pdf/CYPSresource- guide

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Box 1: Chapter structure Executive summary

Introduction Demographics

Maternal health

The best start in life Pregnancy and birth

Infant health

Communicable diseases

Non-communicable Physical health public health priorities

Common long term Mental health conditions JSNA Chapter JSNA Children's social care

Children and Young People's People's Young and Children Specific domains of vulnerability Vulnerable children Children with special educational needs

Outcomes linked to vulnerability

Primary care

Use of services A&E attendances

Hospital admissions

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1.2 Notes on the data

Age range

Throughout this chapter, as far as possible the analysis covers those aged up to, and including, 19 years of age. However, not all available data sources cover this age range; some data cover a narrower range (such as up to and including 16 years of age) and others a wider age range (such as data up to and including 24 years of age). Throughout this report, age ranges have been reported with the data for absolute clarity. However, it should be remembered that differing age ranges do make some data non-comparable.

City of London

The 0-19 population is much smaller in the City of London than in Hackney. This means that some data that are available for Hackney are not available for the City of London, due to low numbers that could make the data identifiable to individual children and/or be unreliable. For instance, while some data are presented at ward level in Hackney, this is not possible for the City of London as each of the City’s 25 wards contain few, and in some cases no, residents. Furthermore, this small population size means that there are no secondary schools based within the City of London; instead, these children attend schools in a number of different neighbouring local authorities, which creates fragmented data.

Statistical peers

Hackney’s statistical peers are local authorities with a similar demographic make up to Hackney, used for the purpose of comparisons. The statistical peers used for comparative analysis throughout this chapter differ from those used in other parts of the JSNA, as they are designed specifically to reflect the local population of children and young people. The statistical peers used throughout this document are listed in Table 1.

Table 1: Statistical peers for Hackney and for the City of London (July 2016) Hackney City of London Brent Barnet Enfield Brighton and Hove Greenwich Camden Hammersmith and Fulham Hammersmith and Fulham Haringey Islington Islington Kensington and Chelsea Lambeth Kingston upon Thames Lewisham Richmond upon Thames Southwark Wandsworth Waltham Forest Westminster Source: Local authority interactive tool [1]

The statistical peers for the City of London must be used with caution, as it contains far fewer residents comparatively – each of the City’s statistical peers contains between 21 and 46 times as many residents as the City. These small numbers mean

Document Number: 17850552 Document Name: JSNA Children and young people - 01 Introduction - FINAL Children and Young People: introduction | 4 that comparisons are less robust than in larger local authorities. Furthermore, some population demographics differ quite significantly; for example, the City of London has a higher proportion of working-age males and a smaller proportion of children than most of its ‘peers’. Therefore, for convenience, throughout this chapter the City’s data are most commonly presented alongside Hackney and Hackney’s statistical peers. However, where in the text the City has been compared to its own statistical peers specifically, the list in Table 1 above has been used.

Independent schools

Hackney and the City of London have a higher proportion of pupils being educated in independent schools (25%) than across London (10%) or nationally (7%). [2] These independent schools are outside of data collection systems for state-maintained schools, and do not routinely provide data for national programmes such as the National Child Measurement Programme (NCMP). This means that the data for some topics, such as obesity, may not cover all local children. As those who attend independent schools may differ in their health needs from other local children (for instance, those in the Orthodox Jewish community), school-based data may not be fully representative.

1.3 Local population context

Age and gender

There are over 60 times as many children and young people aged 5-19 years (inclusive) in Hackney (44,700) than in the City of London (700). [3]

Hackney has a relatively young population compared to national figures, with a greater proportion of people under 40 years of age, and a smaller proportion of people in each age category after 45 years of age (Figure 1). The City of London, however, has a lower proportion of children and young people under 19 years of age than nationally or in Hackney. [3]

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Figure 1: Hackney and UK population age structures (mid-2014 estimate)

Source: Office for National Statistics [3]

Population projections

The 0-19 population is projected to increase across both Hackney and the City of London over the coming years by 800 young people per year to reach 68,900 in 2020. [4] However, as shown in Figure 2, these increases are not uniform. Within Hackney, the projected changes in 0-19 year olds vary from 50 fewer young people in , and wards to 1,200 more young people in ward [4].3,4 The three wards with the highest forecast population increases are located in the Stamford Hill area of the borough – where the majority of the Charedi community are based (see Section 1.4).

3 Population changes have been calculated here using Authority (GLA) estimates for both 2014 and 2020 to allow comparability. 4 These are the pre-2014 wards as the data from GLA have not yet been updated to reflect the new ward boundaries.

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Figure 2: Projected change in 0-19 population by Hackney ward (pre-2014 boundaries) and City of London (2014 – 2020)

New River 1,200 500 Springfield 450 King's Park 400 City of London 350 350 350 350 300 150 150 50 50 - Dalson - - Central - Brownswood -50 Hackney Downs -50 Haggerston -50

Source: Greater London Authority [4]

Sexuality

National data from the 2011 Office for National Statistics (ONS) Integrated Household Survey showed that the 16-24 age group had the lowest proportion identifying as heterosexual/straight and a relatively high proportion of ‘don’t know/refusal’ or no response (Table 2).

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Table 2: Sexual identity by age group, national data (2010/11) 16 -24 25 -34 35 -49 50 -64 65+ Heterosexual/straight 91.4 93.6 94.0 95.2 94.7 Gay/lesbian 1.1 1.4 1.4 0.7 0.3 Bisexual 1.0 0.6 0.4 0.3 0.3 Other 0.3 0.3 0.3 0.3 0.5 Don’t know/refusal 4.9 3.4 3.2 2.9 3.9 No response 1.3 0.7 0.7 0.6 0.3 Source: Integrated Household Survey , Office for National Statistics [5]

1.4 Young people’s ethnicity and migration

Ethnicity

The 0-19 population is more ethnically diverse than the general population across and this is more pronounced in Hackney, the City of London and London overall (Figure 3).

Figure 3: Proportion of population identifying as White British by age group (2011) 0-19 year olds 20+ year olds

81% 75% 59% 47% 47% 39% 37% 28%

Hackney City of London London England

Source: 2011 Census, Office for National Statistics [6]

A greater proportion of Hackney’s 0-19 year olds are Black and a lower proportion are White British in comparison to the City of London (see Figure 4).

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Figure 4: Ethnicity of 0-19 year olds in Hackney and the City of London (2011)

Source: 2011 Census, Office for National Statistics [6]

Language

Three quarters (76%) of Hackney residents and 83% of City residents cite English as their main spoken language, both of which are significantly lower than the national average of 91%. [6] In both Hackney and the City of London, young people are more likely to cite English as their main language than the rest of the local community. This may be a reflection of the fact that a greater proportion of young people were born in the UK. Many people who do not cite English as their main language still report being able to speak English well or very well – 95% of 3-15 year olds in Hackney and 99% in the City of London report being able to speak English well. [6]

Religion

Of the religious groups in Hackney, the Jewish community has the youngest age profile, with half (49.5%) being aged 0-19. [6] This may be a reflection of the high birth rate in this community (see Section 2.1.4) and it could imply that the number of residents identifying as Jewish is set to rise. The local Hindu community has the smallest 0-19 population, at 15.7%.

In the City, just 4.8% of Jewish residents are aged 0-19, compared with 29.6% of Muslim residents.

Orthodox Judaism

For over 75 years there has been a strictly Orthodox Jewish (‘Charedi’) community based in the Stamford Hill area. The vast majority (85%) of this community are based in north Hackney and 16% in south Haringey. 5 Most Charedi infrastructure (including the majority of the educational infrastructure) is based in Hackney. In July

5 Values do not sum to 100% due to rounding.

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2015, the size of the Charedi population in Hackney was estimated to be over 25,000 (corresponding to 9.5% of the total Hackney population). [7] In 2011, an estimated 53.5% of the Stamford Hill Charedi population were under 19 years of age, which equates to 13,400 Charedi children and young people living in Hackney (equivalent to 22% of the total Hackney population). [8] However, another study suggests that this may be an underestimate. [9]

Analysis of 2011 Census data by the Institute for Jewish Policy Research showed a highly skewed age profile of the local Charedi population towards young people compared to Hackney overall (Figure 5).

Figure 5: Population structure of the Stamford Hill Orthodox Jewish community compared to the total Hackney population (2011)

Source: Institute for Jewish Policy Research; Office for National Statistics [10] [6]

Charedi households are large, with an average of 6.3 persons per household (compared to 2.1 across Hackney), and one in eight contain 10 or more people. [9]

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1.5 Young person specific socio-economic factors

Child Well-being Index

The Child Well-being Index (CWI) ranks local authorities across six domains. The rankings for Hackney and the City of London are shown in Table 3.

Box 2: Child Well-being Index (CWI) The CWI contains indicators across a number of child wellbeing-relevant domains, by which the 354 English local authorities can be ranked (with 1 being the best and 354 being the worst). The CWI was released in 2009 and is largely based on data from 2005, or from the 2001 Census and, therefore, the results must be interpreted with caution as they are based on quite dated sources. [11]

Table 3: CWI ranking out of 354 local authorities, where 1 = ‘best’ and 354 = ‘worst’ (2009) Indicators Rank Hackney City of London Health and 0-18 emergency hospital admissions & 312 73 disability outpatient attendances; 0-16 receiving Disabled Living Allowance Education Key Stage 2, 3 & 4 scores; secondary 265 98 school absences; leaving education at 16; not entering higher education under 21 Children in Children (at risk of being) in need 346 174 need Environment Air quality; % of green space; number of 270 354 bird species; road safety 0-16; sports/leisure facilities; distance to school Housing Occupancy rating; shared 352 321 accommodation; homelessness; lack of central heating Crime Burglary rate; theft rate; criminal damage 351 1 rate; violence rate Material 0-15 in households claiming Income 353 219 wellbeing Support, Jobseeker’s Allowance (JSA) or Pension Credit; or claiming Working Tax or Child Tax Credit and income < 60% of median Source: Child Well-being Index, Department for Communities and Local Government [11]

Hackney has an overall ranking of 352, with only two local authorities ranked lower. Hackney fared best on education, the environment and health and disability, and performed worst on material wellbeing, housing, crime and children in need.

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The City of London fares better, with an overall ranking of 284. However, this still places the City of London in the lower half of local authorities nationally. The City of London performed well on crime (having the best score nationally), health and disability, education and children in need, and performed less well on material wellbeing, housing and environment (for which it is ranked last). This dichotomy of rankings is rare and is likely to be a feature of the unusually small geographical area that the City occupies.

Deprivation

Data relating to children living in poverty are discussed in the ‘Society and environment’ JSNA chapter.

Housing

Housing data that concern children – for instance, data relating to overcrowding, tenure and family homelessness – are also discussed in the ‘Society and environment’ JSNA chapter.

1.6 References

[1] “Local authority interactive tool (LAIT),” Gov.uk, July 2016. [Online]. Available: https://www.gov.uk/government/publications/local-authority-interactive-tool-lait. [Accessed July 2016]. [2] “School census,” Department for Education, 2016. [3] “Annual Mid-year Population Estimates: 2014,” Office for National Statistics. [4] “SHLAA Capped Household Size Model Short Term Migration Scenario Ward Projections,” Greater London Authority, 2015. [5] “Integrated Household Survey,” Office for National Statistics, 2011. [6] “2011 Census,” Office for National Statistics. [7] Interlink Foundation, “Size of the Charedi population of Stamford Hill, London,” 2015. [8] L. Mayhew, G. Harper and S. Waples, “Counting Hackney's population using administrative data - an analysis of change between 2007 and 2011,” 2011. [9] C. Holman and N. Holman, “Torah, worship and acts of loving kindness: baseline indicators for the charedi community in Stamford Hill,” Interlink Foundation, 2002. [10] D. Graham, “2011 Census Results (England and Wales): A Tale of Two Jewish Populations,” Institue for Jewish Policy Research, 2013. [11] “Child Wellbeing Index,” Department for Communities and Local Government, 2009.

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